Today on the On Health podcast, I share a very real and much-needed discussion on the impact of racial disparities in birth on Black mothers and families, how we can demand change, and how we can better celebrate Black birthing people, and more with my guest, Kimberly Seals Allers.
Kimberly is an award-winning journalist and author, international speaker, fem-tech founder and a deeply committed advocate for maternal and infant health. Kimberly is former senior editor at Essence and writer at Fortune magazine, a frequent contributor to The New York Times and Washington Post, HuffPost, Slate and others, has appeared on Good Morning America, CNN, Anderson Cooper, and has been featured in various international and national media outlets, including the British Medical Journal, The Guardian (U.K.), Essence, and more.
A graduate of New York University and Columbia University Graduate School of Journalism, Kimberly is a leading voice on the socio-cultural and racial complexities of birth, breastfeeding and motherhood. Her fifth book, The Big Let Down-How Medicine, Big Business and Feminism Undermine Breast-feeding was published in January 2017. In 2018 she was called one of “21 Leaders for the 21st Century” by Women's eNews for her media advocacy work for mothers and children.
Kimberly is not only the creator and co-founder of Black Breastfeeding Week; she has now combined her passions and is leveraging her vision for using technology to amplify community voices to create the lrth app.
And true to the words of the great Maya Angelou, this single mama of two also does it all with passion and style!
Have a listen as Kimberly and I discuss:
- How weathering – the phenomenon of being exposed to ongoing racism – impacts Black pregnant and birthing women
- Kimberly's journey into breastfeeding and birth activism – and how it's a family affair for her
- The Irth app and how Kimberly is challenging medical bias and shining a light on much needed provider and birth space accountability
- Black birthing joy, and how it is possible to hold both celebration for Black birthing people and the reality of the statistics of their experience in the healthcare system
- How we can push for change despite generations of struggle
- And much more!
Please make sure to share this episode and subscribe wherever you listen to podcasts. You can also follow along with the complete interview transcript below, included for your convenience,.
You can find Kimberly and the resources we talk about here:
- Birthright: A Podcast About Joy & Healing in Black Birth
- Learn more about the Irth app
- Follow Kimberly on Instagram
- Get your copy of “The Big Letdown: How Medicine, Big Business, and Feminism Undermine Breastfeeding” here
A Conversation About Birth & Breastfeeding with Kimberly Seals Allers
This conversation has been edited for clarity and length.
Aviva: Welcome everybody to On the Big Letdown, a conversation about birth and breastfeeding with Kimberly Seals Allers.
Before we jump in for this, what I know is going to be an amazing and an exciting interview, I do want to just give a content warning. If you're pregnant, if you're trying to conceive, we will be talking about maternal mortality and also the impact of racism on maternal health. I also just want to say that I am going to be using the words “woman”, “women” and “pregnant women.” If you identify in any other way and don't feel included in that language, I apologize. Please include the language of yourself in this conversation, because this is a space that's open and safe for everyone.
Aviva: Kimberly, welcome to On Health. I have to tell you, I am such a big fan of you. Your boldness, your power, your positivity even in speaking truth, your willingness to say it like it is even when it's not popular. And your style. Girl, you bring it all. I first learned of your work through The Big Letdown in 2017 and continue to follow all that you're doing. Thank you for taking the time to join me on the podcast. I'm excited about your story, what's on your mind; all the things
Kimberly: Oh my goodness, thank you so much for having me. That was an amazing introduction. I was almost like, “who is this person”? So I'm honored to be here and to have this conversation with you today.
Aviva: Even before The Big Letdown, which focused on breastfeeding politics, you wrote the Mocha Manual to Fabulous Pregnancy, a guidebook for black women. In that you stated, “just being a black woman places you at a higher risk of poor birth outcomes, and at the root of it are the stresses of racism and the biased treatment you may receive”. That's a quote from your book. I've also heard you state in various interviews things like “the unique social burdens carried by black women are literally impacting our wombs”. If you will, can you dive into – for those who are listening and not familiar, or those who want to hear your voice on it even if they've heard some of these topics before – how birth disparities are impacting black and brown women? And if you're comfortable talking about it, how your experience becoming a black mother influenced your work.
Kimberly: Yeah, happy to talk about it. I think the first thing that I found very jarring, even in my own pregnancy experience. You know, as you mentioned, I was a journalist, so when I became pregnant, my first thing is research. Let me just research everything. Back then the internet was not what it is today, and as a journalist, I probably had access to more tools than the average person. Shout out to Lexus Nexus or anybody who remembers what that is. I began doing a lot of research – perhaps over researching myself – and quite frankly, I was clueless about racial disparities and birth outcomes. As you mentioned, I was blessed to be educated. I was literally at Columbia Graduate School when I became pregnant. I was blessed to not be poor, and I just had no idea that none of these things were protective factors. In fact, what I know now and what I learned is that actually, income and education are not protective factors for black women as they are for white women.
In fact, a college educated black woman is still more likely to die or have a poor birth outcome than a white woman who has not completed high school. That is what the research shows. When I learned about that, I was petrified. I was just in disbelief. More importantly, the answers that I saw at that time were unacceptable. It was as if black women were some sort of medical mystery. There were very few researchers; Dr. Fleda Mask Jackson at Emory was one of them. There was this burgeoning piece of research, not the robust knowledge that we have today. So I want to honor how far we've come in acknowledging what some researchers call “the weathering process,” and the fact that literally the experience of being a black woman is wearing down our bodies. We actually enter pregnancy in a less healthier state by many measures because of what our bodies endure in terms of the stresses, the ways that racism is impactful.
I could write a whole other book about what I experienced as a black woman at Fortune magazine at that time. These were my stressful experiences. What it was like for me at NYU. I could go on and on and on. What it was like to be a black woman journalist. All of these things take a toll. We are entering pregnancy really in a less healthier state because of all these experiences. Not to mention what my mother experienced in utero – who knows – and what I did to my children around what they experienced in my womb while I was living my life as a black woman at Columbia University Graduate School. These are generational issues that have impact from the womb and are actually compounded by our lived experience. My very first book was my response to that. So I was immediately activated as a researcher, as a journalist, as a person who doesn't like for questions to be unanswered – real pet peeve of mine.
I'm like, “well, there's no satisfactory answer to this question”, so what I really sought to do – and I think The Mocha Manual at the time was very unique because it really was the first of its kind book that was not for medical perspective, but was asking the question, “What are the lived experiences of black women that may be impacting that?” I talked about everything from being at your job and perhaps being the only one, to your relationships, to your finances, to understanding ideas like the Strong Black Women Syndrome and the way that plays out in our responsibilities and expectations that come from our families and communities. All of these things play a part in what's happening to us in our outcomes and then the pieces that we cannot control, which is how we're often treated within healthcare systems and by medical providers. All of this was happening to me and I was deeply concerned that there was information that I needed that was not available to me, and so I wanted to create that for others.
Aviva: Can we talk more about this concept of “weathering”? It's a term that I have come across in the literature to understand, as you said, the impact of all of these factors – all the sociocultural factors of racism. When you study midwifery, when you study obstetrics – I was a midwife first and my midwife mentors happened to have been black midwives, so I saw things from a different lens. But when you study conventionally, we hear things like, “well, black women are more likely to have hypertension”; “black women are more likely to have diabetes”; “black women are more likely to be overweight.” You start to get this sense that, one, there's either something very wrong with the black body if you don't know otherwise, or somehow black women are actually doing something to not be good pregnant people and take care of themselves.
Can you talk about this intersection of blaming black and brown bodies as if somehow black and brown bodies are inherently responsible, and what's really happening?
Kimberly: I mean, first of all, I want to acknowledge – and I always say this to people – that white women have diabetes too. White women are overweight too, and they still survive childbirth. Let's be clear that only black women in this country are hypertensive, overweight or have diabetes. That is an American problem, not a black woman problem. But yet, even in places where white women have very high levels of diabetes and are overweight, they still have better birth outcomes. They don't die from pregnancy and childbirth. I just want to level-set there, that we are not talking about things that are unique. What has happened, to your point, is that the need to problematize black women versus dealing with the very real systemic issues – it's very easy to blame somebody else, to have someone to point the finger at, to say that it's your fault, all these other things.
Of course, if we look up the history in this country of the ways that black people have been ‘problematized,’ it has been historic, and that is the trajectory. If you look at the history of this, once black women stopped having value to the economic system; ‘cause you remember, our babies had value. They were laborers, we had value as feeders and breeders, and we were in many ways protected because we had economic value to the capitalist system, which at that time was chattel slavery. When that changed, and black women no longer had economic value to the capitalist system – where we were not breeders and feeders and could not produce laborers – all of a sudden we became a problem. I want everyone to really acknowledge the trajectory of this narrative, because I've done the research, and so to understand: it was part of a plan to now problematize black women, to make our children a problem.
All of these things are not by happenstance; they are the product of a systemically racism system that has created a narrative to suit what it needs to suit. When we think about this idea of problematizing black women – “it's their fault”, whatever – and then you look at the fact that Serena Williams nearly died, it's like, “well that doesn't jive.” We have one of the most famous celebrities in our world – a true G.O.A.T., as they say – in my book; and I remind folks that she was there with her white, billionaire husband and still was ignored. So what are we doing there, right? Let's talk about Dr. Shalon Irving, an officer with the CDC; the list of women who don't fit that story, there are too many of them for anyone to actually carry water in that story anymore. Just, it's a lie. It's been disproven by research, it's been proven by stories. We know that it has nothing to do with who you are. It has everything to do with how you're treated because of the color of your skin. The research that has removed socioeconomics, has removed health, has removed all these things, we still continue to die. But what's left? People are afraid; they are avoiding the very real conversation that black women are treated differently. Our motherhood is not valued; our lives are not valued; our children are not valued. This country spent years trying to control our reproductive organs through eugenics and making sure that we did not produce children. Now you want me to believe that the fact that I'm dying is just on me? I'm sorry sir. As the children say, “no ma'am, no ma’am”. This is a lie that's been told because it allows people to avoid the reality that people are not being treated the same way, even at the same place. This is the truth that we need to come to grips with and to deal with.
Aviva: And the medical model is just a parallel model to the overall model we have in our society and culture. I mean, the history of racism in our culture is just mirrored exactly in the history of racism in medicine. Mic drop – thank you for everything you just said. I also want to point listeners to authors like Loretta Ross who's been on the podcast, and her book Reproductive Justice, because what we're talking about here – what Kimberly's talking about here – I mean, it's really deep y'all in the whole system of welfare and access to medical care. It is so deep. There's Harriet Washington's book on medical misogyny and medical racism. I hope everyone will really dig in and do some good reading, ‘cause it's powerful.
I would like, if you don't mind, just to name a few names. You mentioned Shalon Irving – one of my favorite quotes that I always come back to is “data is stories with a soul”. There's so many women – Amber Rose Isaac, Sha-Asia Washington. I think Dr. Shanice Wallace was a physician who said, “I'm not well”, and some people say, “oh, maybe she wasn't heard”. It wasn't that she wasn't heard; she was ignored. There's a difference between someone not hearing someone and someone ignoring.
Kimberly: What part of that is intentional? We see this all the time in our Irth App reviews where people are being dismissed, people are being ignored, people are crying out in pain and there's no humanity. That's the story that was told about black women, and black people? Going back to the medical piece, and I'll let you get to your question.
Aviva: No, no, please; it’s better.
Kimberly: Wasn’t it as early as, what, as recent as 2016, 2017, where medical students still believe research – and I'm using air quotes – that said that black women, black people didn't feel pain as white people did? That there was something in our skin that – so again, the lies that have been perpetuated.
Aviva: Or the opposite, which is black people are drug seeking.
Kimberly: Exactly right.
Aviva: When I worked at the hospital, I had a number of patients when I was in internal medicine – ‘cause I did internal and family medicine – who were black folks with sickle cell disease. For those of you who don't know what sickle cell disease is, you can look that up. But I will say, I have rarely ever seen humans in such excruciating pain as when they're having a sickle crisis. This is only black humans, and this has often been a lifelong phenomenon. The sickle crisis recurs, so people need morphine or opioids to treat it, and become tolerant of it.. so I've had situations where I was in the hospital prescribing narcotics to someone and nurses saying to me, “Oh, she or he is just drug seeking”. I'm like, WTF? No. This is repeated all the time in so many ways. But yes, the opposite, kind of like there are these conflicting tropes, if you will. There's also the trope that I've seen happen in the hospital of the black woman who speaks up, but then she's the loud black woman. So then there's that too.
Kimberly: You're damned if you do, damned if you don’t.
Aviva: Yes. I've also had women who have shared with me. I had Dr. Jess on the podcast (she's a psychiatrist in New York), saying that when she was pregnant, she felt like she had to kind of code switch, I guess is what you might say. Getting her prenatal care as a black woman, she would start speaking in doctor language, or recurrently saying that she was a physician to hopefully get heard better or treated with more respect. Was that something you found that you had to do when you were pregnant?
Kimberly: Absolutely, yeah. Not just when I was pregnant, but even as a parent taking my children to the doctor. The first thing I do is look at where they went to school; I'm looking for some sort of connection, some kind of way to validate. I often share how, when my children were young, I kept an outfit pressed at the back of my door because there was no way I was showing up at the hospital in sweatpants and a t-shirt. That wasn't possible, ‘cause I was going to be judged – even if it was two o'clock in the morning – on how we looked. I always had an outfit ready to go. “These are my emergency room clothes”. You can't just walk in and be yourself. I remember taking my son, he had an allergic reaction. We had to go to the hospital. I was very worried about his care. I'm talking to the doctors and I remember them coming back and asking me like, “Oh, what do you do? Are you a teacher or are you a lawyer? We were talking ‘cause we couldn't figure out what you do”. Well, how is that relevant to my son? I said, “Well, most importantly, I'm Michael’s mom”. But of course, they're clueless. You are just telling on yourself that you are sitting around talking about me, trying to figure out what works. Because probably as a self-employed person, my insurance doesn't jive with who they think I am as a person, how I can express myself. People are living in boxes of stereotypes and they're trying to put you in a box. They don't see, they just put you in” the black box”, and then that brings on a whole other level of treatment. It's deeply scary what black mothers go through, because it's not just about pregnancy and childbirth; it’s about getting our children care. It is about being seen and heard when we are fighting for our children, and it continues on the spectrum. That trauma is very real, and I still experience it.
Aviva: I want to just say this huge collective “I'm sorry” on behalf of every physician that has ever mistreated you, and I am deeply grateful that you are here and continue to raise your voice.
There's all of this cultural phenomenon happening – this systemic racism that is weathering women, black women and brown women – and then we know that 60% of maternal deaths are fully preventable with shifts that happen within the medical system and how medicine is practiced. First, what is the intersection? Obviously we can't just fix medicine; we have to fix the culture; we have to fix society. Where are the inroads that can be made? Maybe as part of that, can you talk about your amazing Irth app and how that is contributing to some of this change? I know accountability is an important piece, changing bias is an important piece. What's all of the intersection here of how we make this shift?
Kimberly: Thank you for asking. I think that accountability is the on-road. It is the on-ramp, because we've done all the training. They have been trained to death, but they're still killing people. What's been lacking from all of these processes is any accountability. When I meet with hospitals and providers all the time, I'm like, “Hey, I'm so glad you did that training. Did you ever check back in with the community to see whether that training improved their patient experience?”
When I meet with hospitals, they will tell me, “Oh Kimberly, we haven't had a maternal death in five years, ten years”, as if killing us or not killing us is the goal. When they haven't had a death, they think that they are winning. This is deeply troubling, because when we've made the goal reducing mortality and morbidity, that means that, one, hospital providers think that they deserve a ticker tape parade when they haven't killed anybody in five or ten years. Then I say to them, “Well how many of those people have had a five star experience?” I'll settle for a four.
Aviva: This is back to the idea that a healthy mother and a healthy baby is sort of this biological or physiological response only, as opposed to looking at the whole picture of what makes a human healthy.
Kimberly: Absolutely. What they really mean is a surviving mother. Surviving baby. But this also has to deal with your emotional wellbeing. People are walking out – yes, they are technically alive, but they are traumatized. Is that healthy? I don't think so. How do we change what that looks like? I think that in the narrative of black maternal health, mortality, and morbidity, folks feel like that's the goal, and if they're not doing that, then everything else is great – and, no. What we're really trying to do with Irth is raise the standard to say that black birthing people deserve a five star experience. I will settle for a four, but I will come get you so we can work on getting to a five. First we need to define what that five star experience is and then, by listening to the community, we need to hold folks accountable to it.
In a medical system which measures everything; in hospitals, which measure everything; and they're counting everything, somehow when it comes to efforts to eradicate bias and racism from care and practice in teams, you're allowed to believe that you just need to train it away. That's just not true. It is not true, especially in a system that really prides itself on measurement, accountability, and transparency – except when it comes to this area. That is the movement that we are driving. ‘Cause I think that if we look at everything that we've done – we've done all the training, we've asked all the questions – what we haven't done is held folks publicly accountable.
The second piece of the on-ramp, for me, is looking at consumers, specifically black and brown birthing people, not as the victims, recipients, or targets of this crisis, but as a powerful consumer force. I remind folks that I was in Senior Management Essence magazine; what I saw every day was how powerful black women are as a marketing block, how many people wanted to market to us and sell us things. What if we understand the powerful block that black women are as consumers – that black and brown folks are as consumers – and use that as a tool to move this industry that has proven itself to be slow to move? Let's be clear that our healthcare system is a commercial system and a for-profit system that is focused on cost and not on quality. How do we understand what has moved other business industries, reminding folks I was a writer at Fortune Magazine for many years, and think about this tool as something we can do to help save more mothers and babies, and for them to have more five-star experiences?
Aviva: I feel like we need to always look outside of our profession for answers, and I feel like there's so much that's happened. We’'re not just talking about how people are talked to. I mean, there have been instances of slapping, verbal abuse. It really does get pretty scary and ugly.
Kimberly: Actually, right now in our national database, we have reviews from 48 states plus Hawaii – over 10,000 reviews – and the number one negative experience being reported in Irth right now is “my requests for help were ignored or refused”. Number two is “I was scolded, yelled at or threatened”. Number three is “my pain levels were dismissed”, which as we know is very common. It's also a common thread in pretty much every maternal death story that we've heard about. Number four is “my physical privacy was violated”. Number five is experiencing comments based on racial stereotypes. Too many black women are being judged about their family size, how many children they have, the spacing of their children, being questioned about their marital status, and it is just all based on terrible stereotypes that people have turned into truth. Then that truth now comes and interferes with practice.
Aviva: If we could unpack those (which I know you're doing) and reverse engineer those, what would be, say, five or seven top checks on a five star maternal health experience? Not just the physical aspects, but this bigger picture that we would be looking for, or hoping for hospitals and birthing environments to create.
Kimberly: We really believe that all of this needs to be defined by the community. When we work with hospital pilots – we have one in Detroit, one in Philly, we're signing on three hospitals in California and we're about to work with a number of hospitals in New York City, which I'm excited about – we help them understand that you need hyperlocal information. Racism in New York City is not like racism in Birmingham, Alabama, which is not like racism in Sacramento, California. Let me tell you about that. Understanding that the first thing we have to do is figure out what matters to that community before we even begin to think about what that looks like on a big level.
What my vision is, is that “this is what a five star experience means in New York City. This is what it means in Birmingham. This is what it means in New Orleans and this is what it means in LA”. Because what we're seeing is very different; what people experience is different. How do we understand that some of that is local context and culture? Through that process, we may see what is the same, but right now I am very committed to making sure that we keep this a hyperlocal conversation first before we try to go big picture.
Aviva: Thank you for educating me and clarifying that; that is really informative and helpful. I have a quick question for you, it's just totally personal. When I was going back to get my pre-med training, I already had four kids. I was a home birth midwife in Atlanta and going back to be a physician, and my son who had homeschooled was in college a couple of years early. We did a whole year of physics in the same class at the same college, and I saw your story about your son helping you to create your first iteration of the app. I had to ask you about that; I think mommas will love hearing that story.
Kimberly: Oh my goodness. As you know, our children are our greatest teachers, and I'm so grateful ‘cause my children have been my greatest teachers. My son is a very big math and science kid. He has been a math wizard and a coding person since he was a little boy, and that is not my side of the brain. I will reluctantly give his father credit. Every summer he wanted to go to these coding camps. They are not cheap, and I'd be working to try to save, to send him to these coding camps. Irth really began when I had this idea, and I really thought it could be a way for us to bridge our worlds, because he had a language I didn't understand. He's tired of me talking about breastfeeding.
Aviva I know how my kids would be – I'd be at the dinner table and a woman would call in labor and I'd be like, “Well, what color is it?” Everyone at the dinner would be like… “Mom.”
Kimberly: But I'm sure later on they knew what questions to ask. They know the script. And I tell folks, my son learned to count by helping me at book events and giving people change. He's really been a part of this journey, so I was excited about sharing this idea with him and seeing that he could see that what he was actually excited about could have an application in my world, and vice versa. Irth really started as a mommy son project. I shared with him this idea at the time. NYU, where you shared that I went for undergrad, was offering free classes that were free to alum, so he and I started going to these class. He was probably 12 or 13 at the time, too. We were the only black people there, and I had the nerve to bring my 12 year old.
He learned and he helped create the first wireframes for Irth; these were wireframes that we took to different contests. We would go together and we'd practice our one minute pitch. We had a thing. We had the word BIrth, and he held the ”B” and threw it away, and we would just travel. He went with me to the MIT birth and breastfeeding hackathon, where we ultimately won a prize. It was really that MIT hackathon; those folks turned part of what was Michael's wireframes into our first prototype that allowed me to have something that I could go and get funding again and start to apply for grants. Michael was there with me; he went up on stage for that pitch. He's been a big part of this process. He is interning for the app development team. Last time he got a much better job and I couldn't afford him.
Aviva: That’s amazing, what a great story. I love that. That's really powerful, and I love that intergenerational brain trust creating this amazing thing.
Kimberly: Yes, and that my children have been a part of the solution. My experiences with them were partly of problem identification with my daughter, and that my son has been a part of building a solution to a problem that I initially encountered. Giving birth to his sister is for me a very full circle moment and brings me a lot of pride and joy.
Aviva: Powerful. Our son – our oldest of four – ultimately went on to get involved in healthcare and created an organization called City Block Health, which is based in New York. Do you know City Block?
Aviva: My son is Iyah Romm, who created City Block, based on the same concept you were enlightening me on earlier, that the solutions really do need to be hyper local. I want to switch gears a little bit. It's an extension of the conversation, but you emphasized something so powerful and important, and it seems to be something you're leaning even more into lately. I'm seeing it on your socials, that knowing the data – the statistic itself – the fact of these stark inequities that exist in reality, can actually have a damaging effect on the psyches, and in turn the health of black women. All the things that racism causes are now compounded by the knowing of it when you are pregnant or birthing or postpartum, and you've been doing this stunning work on your Instagram – you now have a phone number you can call – that is focusing on power, strength, and beauty.
My question is all the things, and you go with it where you want to, but the question is really how do mommas and birth workers hold both realities at once? How do we face and address these dire consequences? Black women are now having to do more emotional labor of advocating, when you shouldn't have to be doing that. I don't want to use the word; you should not have to be doing that, but if you don't, you face the consequences. How do you – we – hold the joy, the power, maintain it so that there's not more fear and anxiety adding to the trauma; adding to the hypertension; the pre-eclampsia and the outcomes?
Kimberly: I think it's important to remember that joy and pain can coexist. They wrote a song about it; it's quite popular at every black party. I think as a journalist and a storyteller myself, I understand that line between awareness raising – very important. Unfortunately, in our kind of media system, you have to sensationalize and shock people. Now we have click bait, internet dynamics, et cetera, et cetera. I understand that need, but I think that there's a fine line between the awareness raising that needs to happen for people to respond and react, and fear mongering. And what we found every day, almost, and certainly every week, we were getting these DMs at Irth, on our social media platforms, where people are asking questions like, “Do I need to write a will before I go into labor?”, and men sending me these emails. I'm giving myself goosebumps, recalling them.
They’re so in fear, and I'm like, “this is not the goal”, that we are in fear. Actually, being afraid is not helping your birth outcomes. It could actually become a self-fulfilling prophecy that, now, this fear is impacting your ability to have a positive birth outcome. That's not the goal. So how do we not use fear as a tool? If that's a media strategy, I get that. But for our community, a community that has fear – where fear has been used to control them – that's how they got us here. Scaring us. That's why they lynched us in public – to scare people. Fear has been used as a tool to control. To be clear, fear is being used to control women in birth across the board, but black people have a unique history with fear and control in this country; certainly the violence that was used against us.
Understanding that, how do we do that without causing fear in our community? Yes, we need to be aware, but stoking fear is actually not the direction we need to go in. I really wanted to shift that narrative, or at least add to that narrative. How do we balance it off? I started the Birthright podcast with grant funding, with a specific mission to only tell positive black birthing stories; because I'm like, “What if we could also learn from our joy?” There's this idea that we have to learn from the trauma, we got to learn from the pain, we got to read about the deaths. And I'm like, “Well, people could also learn from what went well when someone had that”. Who was there; where were they; what did they do?”, so that you could have that. It's not just learning from the deaths, the trauma, and the pain porn; there is a possibility for people to learn from joy. What I also found as I was talking to people was that people who had positive experiences felt silenced. They were afraid to speak up because they felt so lucky to have a positive experience, knowing what their sisters have experienced. They didn't want to even share it.
Aviva: Right. It's like survivor guilt.
Kimberly: Exactly. Exactly. We can't have this. Things have gone well, and instead of you sharing your story, you're shamed by it? No, no, no, no, no, no, no, no, no. We have to find a way for these two truths to coexist, because they are coexisting and they do coexist. I would like to create another method of learning. Not only have we been focused on telling these positive stories to close out our season two, we launched the Black Birth Joy Line, where people can call our number (585-55-GETJOY) and hear clips of these powerful, joyful experiences, and get them by text. I'm also excited to share that very soon we will be launching an instructional session for providers, hospitals, and healthcare professionals all around, to say, “We listened in two seasons to 23 positive black birthing stories, including the fathers and others that we interviewed in those episodes. What could we learn from listening to black birthing joy?” We'll be turning those transcripts – the analysis of those transcripts – into something instructional, and that I am super excited about. We hope to get that out there in February and March, as we're working on it now, so that we can start a new way of thinking about how we improve things that is not just about a maternal mortality review board. What about a maternal black joy review board? I just made that up, but I'm excited about it.
Aviva: My gosh, this gives me chills. It's so beautiful. For those who are listening and want to be part of birth change, birth joy, birth activism – you're a busy momma, and I know a lot of mommas who are like, “I know I want to do this, but I don't know how to get involved, and I've got kids”. What do you recommend, and what does your support network look like to keep it all going?
Kimberly: That is a word. What I recommend is to start small, and maybe even start local. It doesn't have to be everyone biting off – but what can you do? We have things where we need you to write your congressman, or can you sign a petition? Groups like Moms Rising and Chamber of Mothers. There are some really great groups that are working to push for the policies that can help all of us. I would certainly ask folks to get involved there. Even if you can just sign a petition, even if you could have a letter sent to your local representative to speak for these issues, I think we all have to start locally. We know that federal government dynamics are – I don't even have a word, but maybe we can start to push for things in our cities and states that now can start this movement upward, while we are also continuing to work on things on a federal level.
I would say do that. It's important for moms to use their voices, for us to push for change. One of the things that saddens me is to see people who are like, “Well, I had to struggle, so you should struggle”, and “I’ve never had paid leave and I had to go back to work”. It's like, I'm so sorry that happened to you; you deserve better. It's not for us to turn motherhood into the Olympics of oppression for each generation to now have it worse and to have the same struggles. Our vision and my vision, and I hope everybody's vision, is that we are improving that experience, and that my children – that my daughter and my daughter's daughter – are not still having the same conversation that we are still having. That they are not still dying at the rates, and they are not still saying, “I don't have time to be a mother”, and “I don't have paid leave to nurse my baby and heal from childbirth”. That can't be anything that anybody wants.
Aviva: About 10 years ago I was giving a keynote. There were three of us giving keynotes at the Massachusetts Perinatal Association; Eugene De Clerk, who's been a big advocate for maternal health and midwifery at Boston University, got up and he literally said, in front of this entire audience of perinatal providers, “I have failed you”. He said, “I've been talking about this for 20 years, and the statistics are worse”. I think it's something really important to emphasize that, just because we're seeing it talked about every two weeks in the New York Times, it doesn't mean it's changing behind the scenes.
I practiced as a midwife in Atlanta, Georgia, which for decades has had the highest maternal and infant mortality rates in the country. It wasn't different then, when I was there 30 years ago. I gave a talk last year to the legislature at lunch, telling them, “Hey – this really hasn't changed in 30 years, and you've got answers here in the form of midwives to meet the needs of every county.” But there are still these systemic – as you said, the federal government. But the state government obstacles are tough too. We do need to keep reaching out, hounding, and making the change. Again, there are the midwives who are still practicing illegally, because that's the commitment to providing the access to care. Georgia has no maternal health in over a hundred counties; no O.B., no prenatal care; no midwives.
Kimberly: One of our episodes was talking about these obstetric deserts in Georgia and the area, and it was talking about the ratio of obstetricians to actual birthing people. I mean, amazing and disgusting at the same time. We have a very complex set of failures in our system across the board. Sometimes geographically; we're failing our rural communities in many ways. It's just untenable on many levels.
Aviva: As a momma holding all this down – I mean, I know what it takes to write a book and to get out there and speak. You're doing it as an independent momma; indie momma; single momma. What does that look like for you? I really know that, well, how do I want to say this? We can set expectations for ourselves. We have to have every single meal on the table; we have to have every home cooked food; we have to do all these things. Then we have these missions, and you're clearly a nurturing, committed, dedicated mom, and you also have a self to take care of. How do you hold it down?
Kimberly: I think a big part of it is I have included my children in that work. They know, for me, birth is the family business, and you – until you're able to do your own business, you're in the family business. I think for me it was to not make that a separate thing; to always find ways to include my children so that they could see it, so that they could be a part of it. I get to go to amazing conferences; they have come with me to those places. Michael was at the USLC, the lactation consultants breastfeeding conference. I was like, “Oh, it's in Phoenix. Come”. I have tried to include them, but also I think that it has been a tremendous learning lesson for them to see – this is the thing I'm most proud of – me building a life around my passion.
They know that this is something that I'm very dedicated to. They know how much it means to me. Because of that, they view it as a team thing. This is not a job that I hate and I talk about it in disgruntled terms, and I'm always an angry person. No. They know that it brings me joy, so they see themselves as part of that. One of the things I'm proud of as a mother is that I have built a team with my children. People always often ask me, how did I do that? They comment on my children. I really don't know; maybe I just got really lucky in their temperaments, but I've always included them. It was always a part of them as much as it was a part of me. Because of that, yes, there have been makeshift meals, but I also worked really hard when I was present to make sure… I didn't want my children to be eating bad food because I had to travel. That meant, for me, I was going to be up on Sunday doing that big thing of lasagna or chili, or planning the meals. That was what I was willing to do for the sake of them feeling like, “Wow, mom had to go, but she tried, right?” Sometimes that meant I had to make the call from another city for the delivery, but just to make sure that I always tried to take care of them and then try to include them in this mission that I was on. To always give space for me to just be present and be their mother. There are times when I am nothing but their mom, and people will come up to my children and they'll be like, “Wow, your mom”, and they're just like, “Oh, I guess so, but she’s just our mom”. So sometimes even they are like, I'm just their mom, and that makes me really happy.
Aviva: I love that. It sounds like you've created such a purpose-driven and nurturing role modeling for them. That was a big thing for me too; when I'm with my kids, I'm with my kids. When I'm doing my work, they're included. I can remember one postpartum visit; the momma told me to bring my two girls along, and my apprentice brought her daughters along, so we had four little faces at the bottom of the bed watching this whole postpartum exam. It’s part of it. They learned so much about life.
Kimberly: Beautiful. Absolutely. What a beautiful gift.
Aviva: It is a gift.
Kimberly: It's a gift. Michael, someday he may choose to have a family, and he knows more about breastfeeding than most young black males his age. For me, my gift is that I have raised someone who understands birth and can answer questions about breastfeeding, who knows that it's important. This is a gift because, as we know, that doesn't really exist. I'm proud to see all of our children growing up by bedsides and talking about breasts as feeding tools, which they are, and understanding their role and all of that.
Aviva: It's a whole form of intergenerational wealth that we're creating. I have one last question for you that I love to ask my guests. If you could tell your younger self anything, give her words of guidance or wisdom, how old would she be and what would you say?
Kimberly: I will answer that with a personal story. As a child, I had a terrible speech impediment. I struggled with words, and I think that's why I was initially drawn to writing – because my words often failed me. I was teased. It was not a good look for Kimberly, and so I was drawn to writing because that's where I had strength; on the page, but not in my spoken voice. I think, when I look at the ways that I've been able to be a powerful speaker, something I take immense pride in is – because I know my story. So I think I would tell my probably six year old self – maybe just about kindergarten, maybe five – that one day you will be a powerful speaker. That you will stand in front of crowds and people will give you standing ovations not for what you wrote, which I think was always my dream, but for what you said. That part, and I'm getting emotional, was something I wish I had known. It's been a delight for me to see this part of myself, and it was something, of all the things that I always wanted to do… ‘cause I wanted to be a writer, but I never saw that type of power for myself. The fact that I've been able to create that and do that has been something that I wish I had known.
Aviva: Wow. Thank you for sharing that. Very personal. Thank you.
Kimberly : You're welcome. You're welcome.
Aviva: Thank you for being you, and all you bring. You're just, you're, what do I say? You're a powerhouse. I don't need to say it, ‘cause everyone can hear it and see it and feel it. Thank you for all the work you're doing for mothers – black mothers. I'm so grateful and appreciative that you're willing to be here and share with the community. I'm learning so much from you as I go along too.
We will put all the links. If you had one link that you wanted people to really know about today, what would it be? We'll put all the links below the show notes to all your many things.
Kimberly: The one link that I would like to share; I think I would like people to listen to the Birthright podcast, and to hear what's possible for black women. We've talked a lot about what's not going well, but I would love for people to hear black women sharing their joy around birth. That would be really important to me. The negative stuff they can get anywhere – it's out there. I would appreciate for people to tune in to some joyful experiences from black women, and to hear how much it means to them; to hear the fathers and black men who talk about their love of their children and their pride in their wife, their fear for their wife, and to know this is real. So I would ask that you share that one – for the Birthright podcast website link.
Aviva: That's so beautiful. What a way to change so many cultural stereotypes that people don't even know that they have, to listen to these powerful stories. I like that you included the stories of black men and black fathers.
I can't wait to meet you somewhere in person, and thank you for all you're doing.
Kimberly: Thank you for all you are doing. I appreciate this conversation and for including me. Thank you so much.
Aviva: Of course. Thank you everyone for listening. Head over to Kimberly's website, podcast, Irth app. Get her book The Big Letdown; get any of her books, all of her books. Obviously, everything she does is phenomenal, high quality, important and culturally shifting.